I step into the courtyard of the HEAL Africa hospital in the Democrat Republic of Congo. To my right are a group of women sitting idly, sewing bracelets, braiding hair, singing and talking in Swahili. The bracelets are sold for $1 a piece as a way for women to support themselves during their stay here. Some of the women are here to receive treatment due to the violent acts of sexual abuse they have lived through. Some of them are the mothers, sisters or daughters of victims and they are here to care for their loved one. All of them are offered the opportunity to learn to sew through the women’s HEALing Arts program, to take literacy classes and to receive spiritual counseling. The intent is to develop community, empowering women in a country devoured by war where they are constantly facing the threat of sexual violence. According to the U.N. Office for the Coordination of Humanitarian Affairs, OCHA, an average of 40 women per day are raped in the province of North Kivu where HEAL Africa is located. Seeing these women smile and talk and sing and sew I am unable to comprehend the reality of their situation.
“Jambo” (hello), I sing out to them. “Jambo san”, they respond with smiles. This is the only bit of Swahili I have mastered, yet, for a moment, we are connected by our shared understanding of words. I continue walking and then hear my name called out in a thick accent, “Loren! Nous chanson!” I turn to see Arriette, a women of 22 years old who I have befriended during my stay. She speaks in French, the national language of the D.R. Congo, and she encourages me to join her and the other women in their dormitory where they are singing and dancing together. Inside we find Kiko, a 20 year old woman who was brought to HEAL Africa a year earlier after being raped by a group of men in her village. The impact left her with fistula, a debilitating genital injury caused by the violent nature of her rape, that had her incontinent and in terrible pain. Heal Africa is one of two hospitals in the North Kivu region that offers medical and surgical treatment for fistula. Many of the women sharing this dormitory are awaiting the surgery Kiko received and are praying for similar results.
Kiko now lives nearby in the city of Goma and has returned while she is on break from the local University so that she can take advantage of the sewing classes taught here. We met earlier in my month long stay when she learned that I teach yoga. Although she had never experienced yoga, she knew that it was part physical exercise, part prayer and she wanted to learn. Although I speak only two words in Swahili and only a little French while she knows very little broken English we have become fast friends. Over the past weeks we have shared our skills, me teaching yoga poses and breathing exercises, her teaching me to sing prayers in Swahili and to dance. Today she invites me into the women’s dormitory where eight women are standing in a line between two walls of metal cots singing and dancing in coordinated movements. They are practicing a prayer they will sing in church the next morning. There are a couple of women sitting in their beds, unable to stand, but sharing in the song. Blankets are in disarray and there is the thick and musty scent of twenty women living in small quarters. I am quickly arranged into their line and I watch for a moment until I catch on and can join in. The song is a joyous one and as our voices blend together I feel expanded and bright. After several rounds we collapse on the ground in laughter. For a moment I forget where I am. Kiko asks me to teach a song and I share a Hebrew prayer to the Shechina, the Hebrew Goddess or feminine soul of God. The women join in, making up sounds where they don’t know the Hebrew and we all smile at its completion. Then they sing a song Kiko has taught me before. With the help of a translator she explained that “this is the song the women sang to me as I was being wheeled away for my operation. They surrounded my bed and their voices gave me hope and inspiration”. Now, as they sing the song together I am reminded of her story and tears come to my eyes.
I traveled to the D.R. Congo with the intention of observing the women’s counseling program here. As a student of Somatic Psychology at the California Institute of Integral Studies I was interested in learning tools for working with women after violent trauma. I expected there to be challenges. Without a shared language, it was very difficult to communicate with the counselors or the women living on site. Often I had the aid of a translator, who was extremely helpful, but could not fully bridge the gap between us. Larger than the language barrier were our cultural differences. In the introduction to his book on the genocide in neighboring Rwanda, We Wish to Inform You that Tomorrow We Will be Killed With Our Families, Philp Gourevitch described landing in the desert surrounded by the realities of war. He said that even as he stood staring at the bodies that remained, hearing the stories of his guides, he could not comprehend the reality of what he was seeing. My experience was much the same. Even after a month spent at HEAL Africa hearing stories first hand over and over from women like Kiko, even after hearing the challenges faced by the group of counselors on staff and even after seeing with my own eyes the men, women and children entering the hospital grounds desperate for help, I had trouble comprehending the reality of life in the D.R. Congo. My own experience in San Francisco is such a far cry from this war torn country and that gap is palpable.
The cultural divide was most obvious to me the day I entered the counseling center and began to ask the questions that were on my mind. I wanted to know the process of care once a woman arrived at the hospital. How did ongoing therapy work? Was there group therapy? What is a signifier of health for a woman? How do they mark improvement or gauge when a woman needs extra attention? I received answers quickly and curtly. When a woman arrives at Heal Africa she meets with a counselor to tell her story. From then on she has the choice to continue meeting with the counselors, but most do not. The goal of care at HEAL Africa is to empower women with job and language skills while building community. I learned quickly that the explanation was given in a curt manner due to the distrust and misunderstandings that have evolved between previous Western therapists or students and these Congolese counselors. I was certainly not the first to arrive with bright ideas for what was needed here and an earnest desire to help. The response I faced was a mix of: ‘You don’t know us,’ and ‘We’ll believe it when we see it.’ I left our first meeting together feeling a little hopeless and filled with questions. What did I have to offer in this culture so vastly different from my own? How did the psychological theories I was studying, theories I imagined could be applied universally, fit in here?
“To date, the study of human development has been based largely on research and theory coming from middle-class communities in Europe and North America. Such research and theory often have been assumed to generalize to all people.” (Barbara Rogoff, 4). The research I have studied over the past year and a half never highlighted this African country where war has been a way of life since the 1400’s, where women are ravaged by sexual violence, and where communal needs are valued above that of the individual. The women at HEAL Africa are not likely to sign up for ongoing counseling or guidance. It goes against the communal ways that are natural to them. They may never be interested in ongoing counseling, individual or group, but they have much to teach about the process of healing in their particular part of the world. “Cultural research has aided scholars in examining theories based on observations in European and European American communities for their applicability in other circumstances. Some of this work has provided crucial counterexamples demonstrating limitations or challenging basic assumptions of a theory that was assumed to apply to all people everywhere” (Rogoff, 7).
Not having such cultural research in front of me to point the way, I understood that, if I was going to make a connection I would need to find what was universal between us and maximize that. In 1860 the German philosopher and physicist Gustav Theodore Fechner laid the foundation for the new study of psychophysics. His desire was to understand the link between the physical and psychological worlds (Geurts, 8). In my desire to build relationships in this new environment, I quickly understood that it was through a shared awareness of bodily stance and movement that we were able to relate emotionally, thus bridging the cultural divide to connect with the women at HEAL Africa. It was with yoga, breathing, dance and song that Kiko and I first sparked a friendship. We made a physical connection, which opened the door to our psychological connection. Those same sensory exercises connected me to the women in the dormitory and later to the counselors working in the hospital. To understand the experience of these women in their world and how they healed through trauma I needed to first understand their sensory awareness. “I believe that in a cultural community’s sensorium we find refracted some of the values that they hold so dear that they literally make these themes or these motifs into ‘body’” (Geurts, 10).
On the afternoon of my final day at HEAL Africa ten counselors joined me for several hours. We stood in a circle, bare feet on soft green lawn, next to the expanse of Lake Kivu under a warm sun. With the help of a translator I guided the women through a basic breathing exercise and slow, gentle movements. One at a time, the women stepped in, guiding the exercises I introduced and adding their own. As our bodies came into synchronistic movement we began to name how we felt: ‘relaxed, lighter, the work of digestion in our bellies, grateful, like laughing, like yelling’. At the mention of yelling we moved into an exploration of anger in our bodies. We stomped our feet, shifting our weight from side to side, we threw our arms forward and heaved our breath out. The result looked much like an African dance but was the natural evolution of our group’s emotion. After some time we collapsed to the ground, laughter returning. As our time together was coming to a close I asked the women if they had any questions of if there was something else they wanted to do. The first to speak was the woman across from me and she said, “I believe that you meditate and I want to try”. In our last moments together we shared breath and as they finally stood to leave I found dripping out of many eyes, the act of having found the bridge between our physical and psychological realms.
What is crucial in my understanding of this experience, first, is the recognition that healing is greatly influenced by culture. The women in the dormitory who were not inclined towards talk therapy, instinctively use music, dance and theatrics as ways to tell their shared story. Together, they release their pain and anger and bring themselves into states of joy and hope. As a therapist, it would be irresponsible to disregard their own methods by trying to insert more Western modalities. Instead, there is a great opportunity to learn from their tools, adding intention to the use of music, dance and theater so that differing emotions may be explored, mirrored and released. Second, is the importance of physical and sensory relating in order for emotional relating to occur. Different cultures create differing cultural bodies, so the first step in relating is to watch, to examine, and to embody with them. As our bodies begin to know and trust in each other, then emotional doors of understanding are opened as well. As my stay in the D.R. Congo was so brief, this work serves as an introduction to my interest in the realm of culture and healing.